Randomized controlled trial of arthroscopic electrothermal capsulorrhaphy with Bankart repair and isolated arthroscopic Bankart repair.

PURPOSE: Electrothermal arthroscopic capsulorrhaphy (ETAC) was introduced as an adjunct to shoulder stabilization surgery to address capsular laxity in the treatment of traumatic anterior dislocation. No previous RCT has compared arthroscopic Bankart repair with ETAC of the medial glenohumeral ligament and anterior band of the inferior glenohumeral ligament versus undergoing arthroscopic Bankart repair alone. Our hypothesis was that there would be no difference in quality of life between these two groups. Complication/failure rates were also compared.

METHODS

Eighty-eight patients were randomly assigned to receive arthroscopic Bankart repair with (n = 44) or without ETAC (n = 44). Post-operative visits occurred at 3, 6, 12, and 24 months with WOSI, ASES, and Constant scores completed, and rates of dislocation/subluxation were determined.

RESULTS

Data on 74 patients were analysed, with the rest lost to follow-up. There were no differences between groups at any post-surgery time points for WOSI, ASES, or Constant scores (n.s.). Eight patients in the no-ETAC group and 7 in the ETAC group were considered failures (n.s.).

CONCLUSIONS

No benefits in patient-reported outcome or recurrence rates using ETAC were found. Mean WOSI scores 2 years post-surgery were virtually identical for the two groups. ETAC could not be shown to provide benefit or detriment when combined with arthroscopic labral repair for traumatic anterior instability of the shoulder.

LEVEL OF EVIDENCE: II.